Inhalational Anesthesia

1994 ◽  
Vol 7 (1) ◽  
pp. 34-42
Author(s):  
G. Benjamin Satterlee
Keyword(s):  
Hepatic Metabolism ◽  
Rapid Onset ◽  
Volatile Agent ◽  
Inhalational Anesthesia ◽  
Duration Of Action ◽  
Solubility Coefficient ◽  
Anesthetic Agents ◽  
Lower Solubility ◽  
Inhalational Anesthetic ◽  
Reflex Movement

Pharmacists have traditionally had little involvement with inhalational anesthetic agents. As the popularity of operating room pharmaceutical care increases, the need for the pharmacist's understanding of the uses and actions of anesthetic agents becomes necessary. This review provides an introduction to inhalational anesthesia, delivery systems, and the agents commonly used in anesthetic practice. Inhalational agents have long been used to provide general anesthesia through combined pharmacological actions. Nitrous oxide and oxygen are delivered as sole gasses or as carrier vehicles for the more potent inhalational anesthetics: halothane, enflurane, isoflurane, sevoflurane, and desflurane. The minimum alveolar concentration (MAC) of anesthetics is a measurement of concentrations that will prevent reflex movement in 50% of patients. A low blood/gas solubility coefficient for inhalational agents is desirable and is equated with low metabolism, rapid onset, and short duration of action. The inhalational agents are depressants to the nervous and respiratory systems and have variable effects on the cardiovascular system. Potent volatile agent induced renal toxicity may be a result of fluorine produced as a byproduct of hepatic metabolism. Newer agents favorably show lower solubility characteristics and increased physical and metabolic stability.

Modern H1- antihistamines in the treatment of allergic rhinitis: focus on bilastine

2021 ◽  
Vol 18 (2) ◽  
pp. 66-76
Author(s):  
Alexander V. Emelyanov ◽  
Galina R. Sergeeva ◽  
Evgenia V. Leshenkova
Keyword(s):  
Allergic Rhinitis ◽  
Experimental Studies ◽  
Hepatic Metabolism ◽  
Rapid Onset ◽  
Perennial Allergic Rhinitis ◽  
National Guidelines ◽  
Duration Of Action ◽  
Ocular Symptoms ◽  
H1 Antihistamines ◽  
Adults And Children

The second generation of H1-antihistamines is approved for the stepwise treatment of seasonal and perennial allergic rhinitis in adults and children by international and national guidelines. They reduce the severity of nasal and ocular symptoms of rhinitis and improve the quality of life of patients. Bilastine, a piperidine derivative, is a novel H1-antihistamine. It has a potent and selective effect on H1- receptors and a rapid onset and long duration of action and substantially reduces nasal and ocular symptoms of seasonal and perennial allergic rhinitis. Bilastine has no clinically substantial hepatic metabolism and has a high safety profile: it has no sedative effect, does not affect cognitive functions, has no cardiotoxic effects, and does not interact with alcohol and benzodiazepines in normal and high doses. Tachyphylaxis does not develop despite long-term (up to 1 year) use. Bilastine is registered for clinical use in adults and children aged 12 years. The results of clinical and experimental studies have demonstrated that bilastine has many of the features of modern H1-antihistamines recommended by international guidelines.

scholarly journals Neuropsychopharmacological effects of midazolam on the human brain

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Junkai Wang ◽  
Pei Sun ◽  
Peipeng Liang
Keyword(s):  
Human Brain ◽  
Rapid Development ◽  
Neural Correlates ◽  
Rapid Onset ◽  
Water Soluble ◽  
Duration Of Action ◽  
Anesthetic Agents ◽  
Alteration Of Consciousness ◽  
The Common ◽  
Different Levels

Abstract As a commonly used anesthetic agent, midazolam has the properties of water-soluble, rapid onset, and short duration of action. With the rapid development in the field of neuroimaging, numerous studies have investigated how midazolam acts on the human brain to induce the alteration of consciousness. However, the neural bases of midazolam-induced sedation or anesthesia remain beginning to be understood in detail. In this review, we summarize findings from neuroimaging studies that have used midazolam to study altered consciousness at different levels and content. We also compare the results to those of neuroimaging studies using diverse anesthetic agents and describe the common neural correlates of anesthetic-induced alteration of consciousness.

scholarly journals Nasal Delivery of Acute Medications for Migraine: The Upper Versus Lower Nasal Space

2021 ◽  
Vol 10 (11) ◽  
pp. 2468
Author(s):  
Vincent Martin ◽  
John Hoekman ◽  
Sheena K. Aurora ◽  
Stephen B. Shrewsbury
Keyword(s):  
Acute Treatment ◽  
Drug Efficacy ◽  
Hepatic Metabolism ◽  
Rapid Onset ◽  
Systemic Circulation ◽  
Nasal Delivery ◽  
Attractive Alternative ◽  
Gi Tract ◽  
Onset Of Action ◽  
First Pass

The acute treatment of migraine requires effective drugs that are well tolerated and provide rapid and consistent pain relief. Oral tablets are the most commonly used acute treatment for migraine; however, their effectiveness is limited by the rate of gastrointestinal (GI) tract absorption and first-pass hepatic metabolism, and they may not be ideal for patients experiencing GI motility issues. Nasal delivery is an attractive alternative route as it may circumvent GI tract absorption, avoid first-pass metabolism in the liver, and potentially reduce the frequency of GI adverse events. The large surface area and high vascularity within the nose may permit rapid absorption of therapeutics into the systemic circulation, allowing for rapid onset of action. However, the site of drug deposition (upper versus lower nasal cavity) may influence drug pharmacokinetics. Most approved nasal migraine therapies target the lower nasal space where the epithelium is less permeable, and they may be quickly cleared away due to increased ciliary function or dripping from the nose or swallowing, resulting in variable absorption and limited bioavailability. Together with its abundant vascularization, relative mucosal thickness stability, and low clearance rates, the upper nasal space harnesses the benefits of nasal delivery to potentially maximize drug efficacy.

Review of Cimetidine Drug Interactions

1983 ◽  
Vol 17 (2) ◽  
pp. 110-120 ◽  
Author(s):  
Eugene M. Sorkin ◽  
Diane L. Darvey
Keyword(s):  
Blood Flow ◽  
Drug Interactions ◽  
Hepatic Blood Flow ◽  
Hepatic Clearance ◽  
Hepatic Metabolism ◽  
Rapid Onset ◽  
Related Drug ◽  
Cytochrome P 450 ◽  
Acid Labile ◽  
Hepatic Cytochrome

The literature on cimetidine drug interactions has been thoroughly reviewed. Several different mechanisms have been proposed for cimetidine-related drug interactions. These mechanisms include: (1) impaired hepatic drug metabolism due to inhibition of hepatic microsomal enzymes, (2) reduced hepatic blood flow, resulting in decreased clearance of drugs that are highly extracted by the liver, (3) increased potential for myelosuppression when administered concurrently with other drugs capable of causing myelosuppression, and (4) altered bioavailability of acid-labile drugs. Cimetidine binds reversibly to the hepatic cytochrome P-450 and P-448 systems, resulting in decreased metabolism of drugs that undergo Phase I reactions (e.g., dealkylation and hydroxylation). In contrast, glucuronidation pathways are unaffected. The rapid onset and reversal of cimetidine's inhibition of hepatic metabolism indicates an effect on hepatic enzyme systems. Cimetidine also has been reported to decrease hepatic blood flow. Drugs that are highly extracted by the liver, such as propranolol, lidocaine, and morphine, may be postulated to have a decreased hepatic clearance. Cimetidine, through its effect on gastric pH, may increase the absorption of acid-labile drugs or may decrease the absorption of drugs. There have been reports of increased potential for myelosuppression when cimetidine is administered concurrently with drugs capable of causing bone marrow suppression. An understanding of the mechanisms involved in cimetidine drug interactions allows the clinician to prevent and predict these interactions.

Human insulin analogs with rapid onset and short duration of action

Peptides ◽  
1992 ◽  
pp. 88-90 ◽  
Author(s):  
H. B. Long ◽  
J. C. Baker ◽  
R. M. Belagaje ◽  
R. D. DiMarchi ◽  
B. H. Frank ◽  
...  
Keyword(s):  
Human Insulin ◽  
Short Duration ◽  
Rapid Onset ◽  
Insulin Analogs ◽  
Duration Of Action

Inhalational anesthetic agents

2015 ◽  
pp. 143-150
Author(s):  
Charles Kates ◽  
Douglas Anderson ◽  
Richard Shamo ◽  
Robert Bosack
Keyword(s):  
Anesthetic Agents ◽  
Inhalational Anesthetic

scholarly journals Clinical Evaluation of Etidocaine in Continuous Caudal Analgesia for Pelvic Floor Repair and Post-Operative Pain Relief

1976 ◽  
Vol 4 (3) ◽  
pp. 239-244 ◽  
Author(s):  
L. T. Seow ◽  
H. H. Chiu ◽  
C. Y. Tye
Keyword(s):  
Pelvic Floor ◽  
Muscle Relaxation ◽  
Rapid Onset ◽  
Onset Of Action ◽  
Double Blind ◽  
Duration Of Action ◽  
Pelvic Floor Repair ◽  
Post Operative Pain ◽  
Caudal Anaesthesia ◽  
Caudal Analgesia

A randomized double-blind trial compared 1·0% etidocaine and 1·5% lignocaine (both with 1/200,000 adrenaline), for caudal anaesthesia for pelvic floor repair. Etidocaine was highly effective for the surgical procedure, with rapid onset of action, adequate muscle relaxation and longer duration of action. Its use for post-operative analgesia may be hindered by the concomitant immobilization of the legs. The problem of tachyphylaxis with etidocaine needs further investigation.

Comparison of Nasal Airway Patency Changes after Treatment with Oxymetazoline and Pseudoephedrine

1987 ◽  
Vol 1 (2) ◽  
pp. 87-94 ◽  
Author(s):  
John T. Connell ◽  
M. Ines Linzmayer
Keyword(s):  
Nasal Congestion ◽  
Rapid Onset ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Night Time ◽  
Duration Of Action ◽  
Airway Patency ◽  
Drug Of Choice

Oxymetazoline (Afrin) and pseudoephedrine (Sudafed) were compared by rhinomanometric measurements using nasal airflow, a parameter of nasal airway patency, and therefore airway congestion. Oxymetazoline had a more rapid onset and duration of action, greater improvement in airway patency, and longer action than pseudoephedrine, the best of the oral decongestants. The decongestive effect was more reliable for oxymetazoline with 28 of 29 subjects experiencing some degree of decongestion compared to 21 of 30 for pseudoephedrine. Utilizing a combination of oral and topical decongestants may result in the most logical regimen for treatment of nasal congestion. Oxymetazoline is the drug of choice for night time decongestion.

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